Splenic irradiation in treating warm autoimmune haemolytic anaemia

H Markus, J C Forfar
1986 BMJ (Clinical Research Edition)  
An elderly man with severe congestive heart failure was noted to have a haemoglobin concentration of 87 g/l and a reticulocyte count of 13%. Direct Coombs test yielded a positive result and the serum contained a moderate amount of warm antibody (IgG class). Steroids were given, but to no avail, and the patient's condition precluded splenectomy. A course of splenic irradiation was therefore tried (midline dose 2000 cGy (rads)), and 60 days later the blood film showed similar appearances to those
more » ... in patients treated successfully by splenectomy. Haemoglobin concentration subsequently rose to normal. Splenic irradiation may offer a simple treatment for resistant warm autoimmune haemolytic anaemia when splenectomy is contraindicated. H P VOLKMANN, MD, research fellow Department of Medicine, Royal Victoria Infirmary, Newcastle upon Tyne M PONCHER, MD, research fellow I HANNING, Bsc, research fellow K G M M ALBERTI, MD, professor of medicine Kommunehospitalet, Aarhus, Denmark H ORSKOV, MD, professor ofexperimental medicine Correspondence to: Dr Leslie. similar age, sex, and weight; seven of the 32 offspring had impaired glucose tolerance. These results indicate that young offspring of selected noninsulin dependent diabetics can show extensive metabolic changes including impaired glucose tolerance. These changes are associated with hyperinsulinaemia and hyperglucagonaemia.
doi:10.1136/bmj.293.6551.839 fatcat:jivxjmsoubea7p4jppgonv66se